皮下埋植式中心静脉导管在化疗患者中的安全性与有效性

[Safety and effectiveness of central vein catheters indwelling with subcutaneous port in patients undergoing chemotherapy].

作者信息

Ge Feng, Cang Jing, Xue Zhang-gang

机构信息

Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2008 Aug 26;88(33):2331-4.

PMID:19087693

Abstract

OBJECTIVE

To investigate the safety and effectiveness of 3 methods of central vein catheters indwelling in cancer patients undergoing chemotherapy.

METHODS

120 cancer patients undergoing long-term chemotherapy (9 months-2 years)were divided into 3 equal groups to be treated via peripherally inserted central catheter(PICC), untunneled central venous catheter (CVC) by repeat venipuncture (20 through jugular vein and 20 through subclavian vein), and implanted subinfuse-port (PORT, 20 through jugular vein and 20 through subclavian vein). The complications of implantation and quality of life were compared.

RESULTS

The early complication of the PICC group was malposition of the tip of catheters; and the early complications of the CVC group included hematoma in the jugular vein subgroup and pneumothorax in the subclavian vein subgroup. The incidence rates of catheter obstruction and thrombosis of the PORT group were significantly higher than those of the other two groups (all P < 0.05). The incidence rate of infection (regional and systemic) of the PORT group was significantly lower than those of the other two groups (both P < 0.05). The satisfaction score during chemotherapy of the PORT group was (5.6 +/- 1.6), significantly higher than those of the PICC and CVC groups [(3.3 +/- 0.8) and (3.9 +/- 0.6) respectively, both P < 0.05], and the satisfaction score between chemotherapy courses of the PORT group was (5.7 +/- 0.7), significantly higher than those of the PICC and CVC groups [(4.5 +/- 0.8) and (4.8 +/- 1.2) respectively, both P < 0.05].

CONCLUSION

The technology of central vein catheter indwelling with subcutaneous port in patients undergoing chemotherapy is effective and safe.

摘要

目的

探讨3种中心静脉置管方法在癌症化疗患者中的安全性和有效性。

方法

将120例接受长期化疗（9个月至2年）的癌症患者分为3组，每组40例，分别采用外周静脉穿刺中心静脉置管（PICC）、经反复静脉穿刺的非隧道式中心静脉导管（CVC，其中20例经颈内静脉、20例经锁骨下静脉）和植入式皮下输注港（PORT，其中20例经颈内静脉、20例经锁骨下静脉）进行治疗。比较3种置管方法的植入并发症及生活质量。

结果

PICC组早期并发症为导管尖端位置不当；CVC组早期并发症中，颈内静脉穿刺亚组出现血肿，锁骨下静脉穿刺亚组出现气胸。PORT组导管堵塞和血栓形成的发生率显著高于其他两组（均P<0.05）。PORT组感染（局部和全身）发生率显著低于其他两组（均P<0.05）。PORT组化疗期间满意度评分为（5.6±1.6）分，显著高于PICC组和CVC组[分别为（3.3±0.8）分和（3.9±0.6）分，均P<0.05]；PORT组化疗间歇期满意度评分为（5.7±0.7）分，显著高于PICC组和CVC组[分别为（4.5±0.8）分和（4.8±1.2）分，均P<0.05]。